| NPI | 1174573125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MO 2008010691) |
| Additional Taxonomies | 208800000X Urology (Licence: CA C135843) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2025-09-08 |